What is female infertility?
The term female infertility refers to the failure to get pregnant despite trying through unprotected sexual intercourse for at least a year. Infertility could be due to issues in the male partner or female partner or both. In many cases, no obvious cause of infertility can be found.
Almost one-third of the cases of infertility are caused by female infertility and the same proportion is due to male infertility. Combined or unknown factors account for the rest. Female infertility affects about 10 percent of all women. Fortunately, most can conceive through proper diagnosis and treatment.
Several factors may increase the risk of developing conditions that can cause female infertility. Older age is one of the most important factors that reduce female fertility. It adversely affects the frequency of ovulation and the quality of the egg. It may give rise to other health conditions that can make conception difficult and at times risky. Advanced maternal age increases the likelihood of chromosomal abnormalities in the eggs.
5 causes of female infertility
However, the five main causes of female infertility include:
- Problems with ovulation: According to a World Health Organization study, ovulatory disorders accounted for a majority (one-fourth) of the total causes of female infertility. The monthly release of the egg or ovum from the ovary is called ovulation. Some women may have infrequent ovulation (oligoovulation) or do not ovulate at all (anovulation). This could be seen in advanced age or due to health conditions, such as polycystic ovary syndrome, thyroid or pituitary disorders, or extremes of weight. Advanced age can affect the quality or health of the ova making conception difficult.
- Conditions affecting the uterus: Because the fertilized ovum is implanted in the womb (uterus), conditions affecting the uterus affect fertility. These abnormalities could be present at birth (such as a septate uterus) or acquired later in life (such as adhesions, polyps, and fibroids).
- Tubal abnormalities: The fallopian tubes carry the ovum from the ovaries to the womb besides acting as a channel for the sperm to travel. Tubal conditions affect fertility. Infections, such as pelvic inflammatory diseases and tubal blockage, are common causes of infertility.
- Endometriosis: The growth of the tissue that lines the inside of the uterus (endometrium) at another site in the body. It may result in infertility through various mechanisms, such as the formation of adhesions, damage to the ovaries by endometrioma formation, and the production of inflammatory substances (such as cytokines and growth factors) that negatively affect ovulation, fertilization, and implantation.
- Hormonal imbalance: Various hormonal disturbances can cause female infertility. These include hyperprolactinemia, polycystic ovary syndrome, and thyroid disorders.
How is female infertility diagnosed?
To diagnose female infertility, your doctor will take your and your partner’s detailed medical history. If infertility in the male partner has been ruled out, further investigations will be done to know the cause of female infertility. They will ask you in detail about your menstrual cycles and any medications you take.
Your doctor will conduct your detailed physical examination including pelvic and breast examination. They may order tests, such as pap tests, blood work, and pelvic ultrasounds. Hormonal levels could be measured through the blood sample. Ovulation tests could be done to look for ovulatory abnormalities.
If needed, your doctor may order more investigations, such as hysteroscopy, hysterosalpingogram, and laparoscopy. Genetic testing could be required to rule out genetic causes of infertility.
How do doctors treat female infertility?
Female infertility is treatable in most cases. The treatment primarily depends on the cause of infertility.
- In some cases, stress may be a major contributor to female infertility. Counseling and reassurance may greatly increase the chances of conception in such cases.
- Medications, such as clomiphene citrate, could be administered to stimulate ovulation in some cases.
- Surgery could be needed in case of structural defects. These include surgeries for removing tubal blockage or adhesions, fibroids, and polyps.
- Hormonal medications could be required to correct any hormonal abnormalities present. These include the treatment of thyroid disorders, hyperprolactinemia, and polycystic ovary syndrome.
- Some women may need artificial insemination or ART (assisted reproductive techniques) to conceive while others may choose to go for surrogacy or adoption.
Causes of female infertility. https://www.uptodate.com/contents/causes-of-female-infertility
Female Infertility. https://medlineplus.gov/femaleinfertility.html
Infertility Risk Factors. https://www.ucsfhealth.org/education/infertility-risk-factors
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